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Patients with extra-renal salt losses complicated by hyponatremia were found to be common-place, and consistent with McCance's description, they excreted urine virtually free of sodium. [22] In 1950, Sims et al, published their work that suggest observed relation between hyponatremia and pulmonary tuberculosis.
The cornerstone of therapy for SIADH is reduction of water intake. If hyponatremia persists, then demeclocycline (an antibiotic with the side effect of inhibiting ADH) can be used. SIADH can also be treated with specific antagonists of the ADH receptors, such as conivaptan or tolvaptan. [citation needed] Another cause is psychogenic polydipsia. [3]
This means that psychogenic polydipsia may lead to test results (e.g. in a water restriction test) consistent with diabetes insipidus or SIADH, leading to misdiagnosis. [14] Dry mouth is often a side effect of medications used in the treatment of some mental disorders, rather than being caused by the underlying condition. [15]
The main clinical difference is that of total fluid status of the patient: CSWS leads to a relative or overt low blood volume [3] whereas SIADH is consistent with a normal or high blood volume (due to water reabsorption via the V2 receptor). [1] If blood-sodium levels increase when fluids are restricted, SIADH is more likely. [13]
Normal volume hyponatremia, wherein the increase in ADH is secondary to either physiologic but excessive ADH release (as occurs with nausea or severe pain) or inappropriate and non-physiologic secretion of ADH, that is, syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH).
V 2 R antagonists have become a mainstay of treatment for euvolemic (i.e., SIADH, postoperative hyponatremia) and hypervolemic hyponatremia (i.e., CHF and cirrhosis). [9] V 2 RAs predictably cause aquaresis leading to increased [Na +] in majority of patients with hyponatremia due to SIADH, CHF, and cirrhosis. The optimum use of VRAs has not yet ...
Treatment of tea and toast syndrome is centered primarily around resolving hyponatremia. Treatment choice depends on the type of hyponatremia. [2] Traditional treatment for hyponatremia depends on the volume load in the person. For those who are euvolemic (normal body volume load), fluid intake should be restricted.
Tolvaptan, sold under the brand name Samsca among others, is an aquaretic drug that functions as a selective, competitive vasopressin receptor 2 (V 2) antagonist used to treat hyponatremia (low blood sodium levels) associated with congestive heart failure, cirrhosis, and the syndrome of inappropriate antidiuretic hormone (SIADH).